Trigeminal postherpetic neuralgia (TPHN) represents a severe neuropathic pain syndrome with challenging therapeutic management. While radiofrequency thermocoagulation (RF-TC), a minimally invasive neuromodulation technique, has demonstrated favorable outcomes in treating thoracoabdominal and lumbosacral PHN, its clinical application in trigeminal nerve distributions remains underexplored. To evaluate gasserian ganglion RF-TC efficacy in moderate-to-severe TPHN and its effects on serum IL-1β and IL-6 levels. This study enrolled 120 eligible patients diagnosed with TPHN at the Department of Cerebrovascular Diseases, Hangzhou Third People's Hospital, between January 2024 and December 2024. Patients were stratified into moderate (n = 60) and severe (n = 60) pain cohorts based on baseline pain severity. Severe PHN patients were randomly assigned to either the RF-TC group (Group A, n = 30) or the control group (Group B, n = 30), while moderate PHN patients were randomized to the RF-TC group (Group C, n = 30) or the control group (Group D, n = 30). All RF-TC procedures were performed via a foramen ovale approach under digital subtraction angiography (DSA) guidance. Visual Analogue Scale (VAS) scores and serum cytokine levels (IL-1β, IL-6) were quantified pre-treatment and at 1-/4-week post-intervention using standardized ELISA protocols. RF-TC groups (A/C) demonstrated significantly lower VAS scores and reduced serum IL-1β/IL-6 concentrations compared to controls (B/D) at both follow-ups (all p < 0.01), with enhanced therapeutic magnitude observed in severe cases. These findings indicate RF-TC's dual mechanism of pain alleviation and systemic anti-inflammatory modulation. Gasserian ganglion RF-TC is a safe, effective TPHN treatment, achieving significant pain reduction and proinflammatory cytokine suppression.
Wu et al. (Tue,) studied this question.